Barry L. Duncan

Footprints of Couple Therapy: Client Reflections at Follow-Up

This study explores client experiences in couple therapy through analysis of written client responses at 6-month follow-up. A subsample participated in a randomized trial comparing outcomes for couples that used routine client feedback with no-feedback couples. Thematic analysis indicates that clients prefer personable and active therapists who maintain neutrality. Women and men expressed dissatisfaction with lack of therapist structuring and challenge. Lack of therapist initiative and flexibility in scheduling emerged as most problematic, with nonfeedback clients most dissatisfied. Most clients rated use of feedback very helpful. The studys method provides a way to use posttherapy client feedback to improve services.

To Intervene or Not to Intervene? That is Not the Question

One more collision of ideologies has made its way into the hearts and minds of therapists. Is it better to intervene or collaborate with the client? While the argument is entertaining, its significance is overstated. Research is demonstrating that the most potent contributor to outcome is the therapeutic alliance. Whats more, how the client perceives the work of therapy matters much more than how the clinician sees it. While we continue our debates, we would be well advised to accommodate our practice to the clients perspective. A case example illustrates the usefulness of enhancing the development of the alliance.

Brief Therapyism: A Neglected Addiction

Given the comparable outcome of short and long term therapy and the pressure of cost effective treatment, brief therapy is spreading rampantly and threatening our profession. Like other epidemics, brief therapyism is producing casualties by exponential growth. This article will examine this bewildering addiction through a process of historical review, identification of etiological factors, diagnostic classification, and elucidation of treatment options. It is hoped that this initial effort will help stop this pernicious disease before it strikes down yet another generation of our best and brightest.